BILL LANT: Looking at Medicaid expansion at the state level

Monday

Apr 8, 2013 at 12:01 AMApr 8, 2013 at 11:41 PM

We had another very eventful week with some extremely interesting events. We made history on Wednesday, when for the first time a bill proposing Right to Work was voted out of committee. I proposed a committee substitute and combined all three bills that we had heard and added ballot language to the bill. If the bill should be considered for debate on the floor, the ballot language is already set up.

We decided to approach the proposal as a ballot initiative in order to allow every voter the opportunity of helping decide the issue. So far, all that we have done is heard the bills in committee and voted them out.

There is still a long and arduous process before it is actually put before the voters, but this opens up discussion and lets people look at the issue. I also had a hearing for Senate Bill 28. Senator Brown has a bill that would create paycheck protection for public bargaining units. The bill simply requires an employee who is a member of a union to provide his employer written instructions once a year for his paycheck deductions. Sen. Brown testified that many of his constituents complained that their dues were being spent on things they did not approve of. We will have the opportunity to debate this bill on the floor in a couple of weeks.The governor surprised all of us by asking the speaker for permission to address the Majority Caucus. Naturally, the speaker set up a meeting and the governor spent about an hour pitching the Medicaid Expansion to us. The Supreme Court decision last summer makes Medicaid expansion optional for the states.

Although he prefers flat out expansion at any cost, he was willing to consider a proposed plan for reform from House republicans. Obama Care will eventually force some kind of reform at the state level, but even as I write this report, the federal government is extending deadlines. There is just way too much cost for us as a state to buy into the program as proposed.

We have identified several key components we feel are critical to making the system a high-quality safety net. • Encourage free-market principals and competition to lower costs.

• Give Medicaid recipients the power to choose the plan that best fits their solution.

• Incentivize preventive care.

• Promote price transparency to allow recipients to shop for the most cost-effective medical solutions • Demand less federal oversight and more flexibility. Empower our state to adapt to the program to meet the needs of Missouri’s population and an ever-evolving health care industry.

• Reaffirm Medicaid’s original purpose: To serve as a safety net for our most vulnerable citizens: Seniors, children, and the disabled.

These are not a final solution to the Medicaid crisis by any means, but it is a starting point. There are innovative solutions being tried by other states. Arkansas for example is pushing for a system that would enroll those people newly eligible for Medicaid into the same private insurance plans available to individuals and small businesses. However we decide to proceed, we are dependent on the federal government to grant us a waiver that empowers our state to transform our Medicaid system.

We moved along several bills last week that had very little opposition. HB440 allows cottage food producers to continue selling products at farmer’s markets, fairs, and to friends without the intervention of government by way of health department inspections.

HB451 will allow counties to decrease their budgets during their fiscal year. In the event of dramatic declines in revenue or catastrophic expenses, counties will be able to respond responsibly.

HB168 allows returning veterans to apply to two- and four-year colleges with a residency waiver. I hope this encourages all our returning vets to enter school in a Missouri institution.

This week we will start debate on some of the Senate bills that are coming over as well as some of our more complex legislation.

I should have a bunch to report on next time, until then, I am and remain, in your service.

Bill Lant represents the people of Southwest Missouri in the Mo. House of Representatives. Contact him locally at 437-8223 or at his Jefferson City office at (573) 751-9801 or email him at bill.lant@house.mo.gov.